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Treatment Provided in Children and Adolescents with Functional Seizures-A Danish Nationwide Cohort
Nana Brandborg Sørensen1,2, René Ernst Nielsen1,2, Ann-Eva Christensen1
1Unit for Psychiatric Research, Psychiatry, Aalborg University Hospital, 9000 Aalborg, Denmark.
Insights
Treatment for functional seizures (FS) in children and adolescents is individualized, with psychoeducation and outpatient care being common. Improved multidisciplinary collaboration and clinical guidelines are needed for better outcomes in pediatric functional seizures management.
Area of Science:
- Neurology
- Pediatrics
- Psychiatry
Background:
- Functional seizures (FS) are paroxysmal episodes of involuntary movements and altered consciousness.
- FS lack typical electroencephalography changes seen in epilepsy.
- A multidisciplinary approach is considered the standard of care for FS treatment.
Purpose of the Study:
- To examine cross-sectoral collaboration in treating children and adolescents diagnosed with FS.
- To investigate the treatment modalities utilized for pediatric FS patients.
Main Methods:
- A nationwide Danish cohort of 334 children and adolescents (aged 5-17) with validated FS diagnoses (2004-2014) was studied.
- Medical records from diagnosing hospital departments were analyzed.
- Management and treatment modalities within three months post-diagnosis were explored.
Main Results:
- Psychoeducation (86.5%) and outpatient follow-up (70.6%) were the most frequent treatments.
- Cross-sectoral collaboration was initiated in 29.3% of cases.
- The combination of psychoeducation, outpatient care, and psychotherapy was rarely used (4.2%).
Conclusions:
- Treatment for pediatric functional seizures is individualized, with varied use of modalities.
- Further exploration of clinical guidelines and multidisciplinary approaches is recommended.
- Enhancing collaborative care is crucial for improving treatment outcomes in young FS patients.
Background:
Functional seizures (FS) are episodes of paroxysmal involuntary movements and altered consciousness without the typical changes in the electroencephalography as with epilepsy. A multidisciplinary approach is the golden standard in the treatment of FS. This study examined the cross-sectoral collaboration and treatment modalities provided to children and adolescents after a diagnosis of FS.
Method:
A Danish nationwide cohort, consisting of 334 children and adolescents, aged 5-17 years, with a validated diagnosis of FS during the period 2004-2014 was studied. Medical record data were collected from diagnosing hospital departments. Management and treatment modalities from the time of diagnosis up to three months after diagnosis were explored.
Results:
The most used treatment modalities were psychoeducation (n = 289, 86.5%) and follow-up in outpatient care (n = 192, 70.6%). A cross-sectoral collaboration was initiated for a third of cases (n = 98, 29.3%). The most commonly provided treatment combination consisted of psychoeducation, follow-up in outpatient care and psychotherapy; however, only a few patients received this specific combination (n = 14, 4.2%).
Conclusions:
The treatment applied was individualized and consisted of varying use of treatment modalities. Initiatives to curate clinical guidelines and implement a multidisciplinary treatment approach should be further explored to improve treatment for this young group of patients.
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